May 26, 2011

Fibroids: How Do You Know You Have Them and What to Do About Them

You may not know if you have fibroids as they do not always cause symptoms. The most common symptom caused by fibroids is heavy menstrual bleeding. Other common symptoms may include prolonged periods, bleeding or spotting between periods, frequent urination, constipation, pelvic pain or pressure that does not go away, painful intercourse, and lower back pain or leg pains. Infertility and miscarriages have also been associated with fibroids.

Most of the time, no treatment is needed for fibroids unless they cause symptoms. Both medical and surgical methods of treatment are available depending upon the symptoms and ones wishes for future child bearing. Medical therapies are largely aimed at symptom relief and include non-steroidal anti-inflammatory agents such as Ibuprofen in an attempt to diminish pain and bleeding. More advanced therapies such as Gonadotropin Releasing Hormone (GnRH) agonists which may temporarily shrink fibroids have also been tried especially in women close to menopause because fibroids depend on the hormone estrogen to grow and therefore may shrink after menopause when estrogen levels drop. GnRH agonists are also sometimes used for those contemplating minimally invasive surgical removal of large fibroids. Fibroids may be amenable to removal by either laparoscopy or hysteroscopy as a Day Surgical procedure. Robotic surgery is being used for very large fibroids that used to require an abdominal approach. Sometimes, however, an abdominal approach may be necessary for fibroid removal. This procedure is called a myomectomy. For those needing a permanent solution, hysterectomy may be indicted. Hysterectomy is a major surgical procedure that removes the uterus preventing fibroid return. Some women may be candidates for uterine embolization which is a radiological procedure that cuts off the blood supply to the fibroid. This method is not recommended for women desiring future children.

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Joseph A. Hill, III, M.D.

Joseph A. Hill, III, M.D. Board-Certified in Reproductive Endocrinology and Infertility